Endoscopic management of Dieulafoy lesions of the stomach: a case study of 26 patients.
OBJECTIVE
We studied the clinical features and therapeutic outcome in patients with a diagnosis of Dieulafoy lesion.


METHODS
Twenty-six patients who had upper gastrointestinal bleeding from Dieulafoy lesions received endoscopic therapy. The clinical and endoscopic features, and the outcome of therapy, were analysed retrospectively.


RESULTS
Hemostasis was attempted by hemoclipping in 18 patients, heater probe in six patients and ethanol injection in two patients. The initial therapy was successful in 22 (84.6%) cases. Hemostasis was achieved with additional endoscopic therapy in three cases (11,5%). Surgical treatment was needed only in one case, owing to uncontrolled bleeding. One patient died during the hospital stay from a cause unrelated to the Dieulafoy lesion. There were no side effects related to endoscopic therapy. None of these patients presented with rebleeding from Dieulafoy lesions over a mean long-term follow-up of 36 months.


CONCLUSIONS
Bleeding from Dieulafoy lesions can be managed successfully by endoscopic methods, and these should be regarded as the first choice in their management. We emphasize the role of hemoclipping, a mechanical method, for the endoscopic treatment of these lesions.
Parra-Blanco
A
A
Showa University School of Medicine, Fujigaoka Hospital, Department of Internal Medicine, Yokohama, Japan.
Takahashi
H
H
Méndez Jerez
P V
PV
Kojima
T
T
Aksoz
K
K
Kirihara
K
K
Palmerín
J
J
Takekuma
Y
Y
Fuijta
R
R
D001165:Arteriovenous Malformations / Q000150:complications / Q000628:therapy*; D004564:Electrocoagulation; D000431:Ethanol / Q000627:therapeutic use; D005260:Female; D006471:Gastrointestinal Hemorrhage / Q000209:etiology / Q000628:therapy*; D016558:Hemostasis, Endoscopic / Q000379:methods*; D006489:Hemostatic Techniques; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D013270:Stomach / Q000098:blood supply*
D000431:Ethanol